Spotlight on Research: Studying the Developing Fetal Brain

Tuesday, March 5, 2013

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An image from a fetal MRI

Image of the brain from a fetal MRI

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As I mentioned in a previous post, I’m currently pregnant with my second child. Working at a children’s hospital has its pros and cons when you’re expecting. On the one hand, I’m paranoid about every congenital problem imaginable. On the other, if I had an abnormal test or scan, I’d know exactly where to go. If there was something wrong with the heart, I could go to our fetal cardiology team, some of the best in the business. Congenital heart disease is the number one birth defect, affecting about 40,000 babies each year, so it’s not an uncommon reality for many families.

But what’s interesting is that many of these children have developmental delays, probably linked to the loss of blood flow, although researchers are trying to learn why and how this happens. It’s a big focus for our cardiology and critical care teams. My colleague told me about a study going on through our Research Institute, looking at how the fetal brain develops. Through MRI – non-invasive, safe imaging – researchers can look at the brain and try to develop early markers of health. But to do that, they need healthy fetuses, so I volunteered to undergo an MRI at 21 weeks.

I spoke with Catherine Limperopoulos, PhD, who runs the Advanced Pediatric Brain Imaging Research Lab, to try to learn more about what they’re looking for in the MRI images. Dr. Limperopoulos, who just had her second baby, says the long-term goal of her research is preventing brain injury and minimizing the effects of brain injuries.

Right now, she says, “we’re trying to understand what goes wrong in fetal development by understanding what is normal and what is not. We need healthy fetuses to do that.”

By using quantitative MRI, Dr. Limperopoulos and her team can look at brain metabolism to give clues as to when a baby is getting low on oxygen. By studying normally developing babies, Dr. Limperopoulos hopes to plot normal brain growth and development. I liken it to the charts that measure head circumference and abdomen size that the radiologist showed me during my 20-week ultrasound that help determine if the size is where it should be. Right now, such a chart for “normal” brain development doesn’t exist.

“There is nothing more stressful than having a test out of the normal range, but right now, we can’t say definitively what normal is,” explains Dr. Limperopoulos, describing that “gray zone” of borderline test results.

So far, the team has studied about 150 healthy pregnancies, making it the largest database. As for my own experience with the MRI, it was a little loud and I had to sit still for quite some time, but it was easy. And I got some pretty fantastic pictures (see one example at left). I’m supposed to go back during my third trimester.

Dr. Limperopoulos says the third trimester is a time of “exuberant changes, especially in the brain.” She said babies require more energy during the third trimester, so the research team can see changes – and potential problems – during that time.

Dr. Limperopoulos says that the information they receive from these studies is invaluable – both to the researchers and the parents of high-risk babies. She says that if she can alleviate some stress on families, she would consider her work a success. And if I can contribute in some small way, I’m glad to do it.

Did you have an abnormal test during pregnancy? How did it affect your family and your pregnancy?